Registered Nurse (RN) - Case Manager - Anderson

Insight Hospital & Medical Center-posted 2 months ago
Entry Level
Cincinnati, OH
501-1,000 employees
Hospitals
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The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods), assesses, plans, implements and evaluates the options and services required to meet an individual's health and health related needs, including social- determinants that affect ones' overall wellbeing. The RN Care Manager is responsible for screening, identification, and assessment of individuals in need of active Case Management services and promotes the right resources, at the right time and at the right place.

  • Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors.
  • Plans with the patient, caregivers and members of the healthcare team to maximize health care responses, quality and cost-effective outcomes.
  • Monitors and revises the plan as indicated when patient condition changes.
  • Completes all necessary documentation and maintains clear, concise, and timely documentation in the patient record.
  • Ensures patient's and caregiver's treatment goals and preferences are incorporated into the transition of care planning.
  • Follows standardized practices and processes related to Advance Care Planning, Length of Stay management and readmission prevention.
  • Supports denial prevention related to medical necessity through addressing/removing barriers to progression of care.
  • Participates in Interdisciplinary Discharge Rounds.
  • Supports and promotes assertive, proactive care for patients, assisting in removing barriers related to achieving timely testing and treatment.
  • Works in collaboration with revenue cycle partners to help remove barriers to ensure patients are in the appropriate classification.
  • Works in conjunction with patient access to ensure all regulatory letters are delivered to the patient in a timely manner.
  • Participates in department clinical outcome projects as well as process improvement initiatives within the care management department.
  • Works collaboratively with peers to achieve facility and department goals.
  • Shares responsibilities, promoting team-based approach to accomplish work.
  • Maintains strong collaborative partnerships with other members of the care team.
  • Supports and follows compliance rules and regulations as mandated by CMS and Conditions of Participation for discharge planning and utilization management.
  • BLS Basic Life Support - American Heart Association (required)
  • RN License in the state in which they are working or covered by compact (required)
  • 1 year of experience in clinical setting (required)
  • Bachelor of Science in Nursing (preferred for BSMH, required for RSFH)
  • Accredited Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM) from Commission for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management board certification (preferred)
  • 3 years of experience in an acute care clinical setting (preferred)
  • Ambulatory or post-acute care coordination experience (preferred)
  • Comprehensive, affordable medical, dental and vision plans
  • Prescription drug coverage
  • Flexible spending accounts
  • Life insurance w/AD&D
  • Employer contributions to retirement savings plan when eligible
  • Paid time off
  • Educational Assistance
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